scholarly journals A network meta-analysis of randomized controlled trials comparing treatment modalities for de novo superficial femoral artery occlusive lesions

2017 ◽  
Vol 65 (1) ◽  
pp. 234-245.e11 ◽  
Author(s):  
Constantine N. Antonopoulos ◽  
Spyridon N. Mylonas ◽  
Konstantinos G. Moulakakis ◽  
Theodoros N. Sergentanis ◽  
George S. Sfyroeras ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
De Novo ◽  
Meta Analysis ◽  
Treatment Modalities ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Steroid therapy for COVID-19: A systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Tarun Krishna Boppana ◽  
Saurabh Mittal ◽  
Karan Madan ◽  
Anant Mohan ◽  
Vijay Hadda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Randomized Controlled Trials ◽  
Steroid Therapy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Treatment Modalities ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled

There is an urgent need for effective treatment modalities for coronavirus disease 2019 (COVID-19). Data for the use of steroids in COVID-19 is emerging. We conducted this systematic review and meta-analysis to estimate the effectiveness of steroid administration in mortality reduction due to COVID-19 compared to the control group. A systematic search of the Pubmed and Embase databases was performed to extract randomized controlled trials (RCTs) regarding the use of steroid therapy for COVID-19. An overall and subgroup (based upon the type of steroid) pooled mortality analysis was performed, and odds ratios were reported. Cochrane risk of bias assessment tool was used to assess the risk of bias. Heterogeneity was assessed using the I2 statistic. Six RCTs, including 7707 patients, were selected for review. Three trials reported 28-day mortality, and two trials reported 21-day mortality, and one trial reported in-hospital mortality. There were 730 deaths among 2837 participants in the steroid group while 1342 deaths among 4870 patients randomized to the control group (Odds ratio 0.76, 95% confidence interval 0.58-1.00, p=0.05). The effect was significant in patients on oxygen or mechanical ventilation. There was no difference in the various preparations and doses of the steroids. There was heterogeneity among the trials as the I2 value was 53%, with a p-value of 0.06. There was no indication of increased serious adverse events. This meta-analysis of RCTs demonstrated that the use of systemic corticosteroids is associated with a reduction in all-cause mortality in patients with COVID-19 on oxygen or mechanical ventilation.

scholarly journals Incidence of anterior uveitis in patients with axial spondyloarthritis treated with anti-TNF or anti-IL17A: a systematic review, a pairwise and network meta-analysis of randomized controlled trials

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Damien Roche ◽  
Martin Badard ◽  
Laurent Boyer ◽  
Pierre Lafforgue ◽  
Thao Pham
Keyword(s):  
Randomized Controlled Trials ◽  
Anterior Uveitis ◽  
Axial Spondyloarthritis ◽  
De Novo ◽  
Meta Analysis ◽  
Safety Data ◽  
Preventive Treatment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Asas Criteria

Abstract Background Anterior uveitis (AU) is the most frequent extra-articular feature of axial spondyloarthritis (axSpA). We aimed to assess and compare the incidence of AU in axSpA patients treated with anti-TNF or anti-IL17A. Methods We systematically reviewed PubMed, EMBase, and Cochrane from inception to May 3, 2020, and searched for placebo-controlled and head-to-head randomized controlled trials (RCTs) assessing anti-TNF monoclonal antibodies (mAb) or soluble receptor fusion protein or anti-IL17A in patients with axSpA according to ASAS criteria and reporting safety data on AU. Data were extracted following a predefined protocol. We did pairwise and network meta-analyses for the primary outcome of AU flares (relapse or de novo) incidence and estimated summary odds ratios (ORs). We assessed the quality of evidence using the Cochrane risk-of-bias 2.0 tool. We ranked treatments according to their effectiveness in preventing AU flare using the P-score. Results We identified 752 citations and included 33 RCTs, comprising 4544 treated patients (anti-TNF mAb 2101, etanercept [ETN] 699, anti-IL17A 1744) and 2497 placebo-receiving patients. Incidence of uveitis was lower with anti-TNF mAb versus placebo (OR = 0.46; CI 95% [0.24; 0.90]) and versus anti-IL17A (OR = 0.34; CI 95% [0.12; 0.92]. According to the P-score, the ranking from the most to the least preventive treatment of uveitis flare was as follows: anti-TNF mAb, ETN, placebo, and anti-IL17A. Conclusion In RCTs assessing anti-TNF and anti-IL17A in axSpA, incident uveitis are rare events. However, this network meta-analysis demonstrates that anti-TNF mAb are associated with a lower incidence of uveitis compared to placebo and anti-IL17A.

Hiccups: A Non-Systematic Review

2020 ◽  
Vol 16 ◽  
Author(s):  
Alexander K. C. Leung ◽  
Amy A.M. Leung ◽  
Alex H.C. Wong ◽  
Kam Lun Hon
Keyword(s):  
Randomized Controlled Trials ◽  
Case Reports ◽  
English Literature ◽  
Meta Analysis ◽  
Medical Intervention ◽  
Lifestyle Changes ◽  
Treatment Modalities ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Intractable Hiccups

Background: Hiccups are a universal phenomenon. They are usually benign and self-limited. Persistent or intractable hiccups, although rare, can be debilitating and may indicate the presence of an underlying pathological process. Objective: To familiarize physicians with the pathophysiology, etiology, evaluation, and management of children with hiccups. Methods: A search was conducted on December 10, 2019 in Pubmed Clinical Queries using the key terms "hiccup" OR “hiccough” OR “singultus”. The selected publication types included all clinical trials (including open trials, non-randomized controlled trials, and randomized controlled trials), observational studies, and reviews (including meta-analysis and narrative reviews) published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. Results: Overdistension of the stomach is the most commonly identifiable cause of acute hiccups, followed by gastroesophageal reflux and gastritis. Other causes of hiccups, notably persistent and intractable hiccups, include an underlying gastrointestinal, neurological, cardiovascular, pulmonary, infectious, and psychogenic disorder. Persistent or intractable hiccups can be a harbinger of serious medical pathology. A detailed history and thorough physical examination may provide clues for the etiology of the hiccups. The treatment of hiccups should be directed at the underlying cause whenever possible. Bouts of acute hiccups less than 48 hours rarely require medical intervention as they usually resolve within minutes. Treatment may be considered when hiccups are bothersome, persistent, or intractable. Treatment modalities include lifestyle changes, physical maneuvers, pharmacotherapy, and very rarely, surgical intervention. Conclusion: Acute hiccups are usually benign and self-limiting. Persistent or intractable hiccups can be a harbinger of serious medical pathology. The underlying cause should be treated if possible. There are no formal guidelines to the treatment of hiccups. Currently, most of the methods proposed are based on case reports and anecdotal evidence. Terminating an episode of hiccups can be very challenging for a clinician but may tremendously improve the patient’s quality of life. It is hoped that future well-designed and better-powered studies will provide us with more information on the efficacy of various treatment modalities for hiccups.

scholarly journals Drug-Coated Balloon for De Novo Coronary Artery Lesions: A Systematic Review and Trial Sequential Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Wei Liu ◽  
Min Zhang ◽  
Guangping Chen ◽  
Zongzhuang Li ◽  
Fang Wei
Keyword(s):  
Systematic Review ◽  
Coronary Artery ◽  
Randomized Controlled Trials ◽  
De Novo ◽  
Meta Analysis ◽  
Bleeding Risk ◽  
Controlled Trials ◽  
Coronary Artery Lesions ◽  
Randomized Controlled ◽  
Drug Coated Balloon

Objective. To investigate the efficacy of drug-coated balloon (DCB) treatment for de novo coronary artery lesions in randomized controlled trials (RCTs). Background. DCB was an effective therapy for patients with in-stent restenosis. However, the efficacy of DCB in patients with de novo coronary artery lesions is still unknown. Methods. Eligible studies were searched on PubMed, Web of Science, EMBASE, and Cochrane Library Database. Systematic review and meta-analyses of RCTs were performed comparing DCB with non-DCB devices (such as plain old balloon angioplasty (POBA), bare-metal stents (BMS), or drug-eluting stents (DES)) for the treatment of de novo lesions. Trial sequential meta-analysis (TSA) was performed to assess the false positive and false negative errors. Results. A total of 2,137 patients enrolled in 12 RCTs were analyzed. Overall, no significant difference in target lesion revascularization (TLR) was found, but there were numerically lower rates after DCB treatment at 6 to 12 months follow-up (RR: 0.69; 95% CI: 0.47 to 1.01; P=0.06; TSA-adjusted CI: 0.41 to 1.16). TSA showed that at least 1,000 more randomized patients are needed to conclude the effect on TLR. A subgroup analysis from high bleeding risk patients revealed that DCB treatment was associated with lower rate of TLR (RR: 0.10; 95% CI: 0.01 to 0.78; P=0.03). The systematic review illustrated that the rate of bailout stenting was lower and decreased gradually. Conclusions. DCB treatment was associated with a trend toward lower TLR when compared with controls. For patients at bleeding risk, DCB treatment was superior to BMS in TLR.

scholarly journals Incidence of Anterior Uveitis in Patients with Axial Spondyloarthritis Treated with Anti-TNF or Anti-IL17A: A Systematic Review, A Pairwise and Network Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Damien Roche ◽  
Martin Badard ◽  
Laurent Boyer ◽  
Pierre Lafforgue ◽  
Thao Pham
Keyword(s):  
Randomized Controlled Trials ◽  
Anterior Uveitis ◽  
Axial Spondyloarthritis ◽  
De Novo ◽  
Meta Analysis ◽  
Safety Data ◽  
Preventive Treatment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Asas Criteria

Abstract Background: Anterior uveitis (AU) is the most frequent extra-articular feature of axial spondyloarthritis (axSpA). We aimed to assess and compare the incidence of AU in axSpA patients treated with anti-TNF or anti-IL17A. Methods: We systematically reviewed PubMed, EMBase and Cochrane from inception to May 3, 2020, and searched for placebo-controlled and head-to-head randomized controlled trials (RCTs) assessing anti-TNF monoclonal antibodies (mAb) or soluble receptor fusion protein or anti-IL17A in patients with axSpA according to ASAS criteria and reporting safety data on AU. Data were extracted following a predefined protocol. We did pairwise and network meta-analyses for the primary outcome of AU flares (relapse or de novo) incidence and estimated summary odds ratios (ORs). We assessed the quality of evidence using the Cochrane risk-of-bias 2.0 tool. We ranked treatments according to their effectiveness in preventing AU flare using the P-score.Results: We identified 752 citations and included 33 RCTs, comprising 4544 treated patients (anti-TNF mAb: 2101, etanercept [ETN]: 699, anti-IL17A: 1744) and 2497 placebo-receiving patients. Incidence of uveitis was lower with anti-TNF mAb versus placebo (OR = 0.46; CI95% [0.24; 0.90]) and versus anti-IL17A (OR = 0.34; CI95% [0.12; 0.92]. According to the P-score, the ranking from the most to the least preventive treatment of uveitis flare was as follows: anti-TNF mAb, ETN, placebo, anti-IL17A. Conclusion: In RCTs assessing anti-TNF and anti-IL17A in axSpA, incident uveitis are rare events. However, this network meta-analysis demonstrates that anti-TNF mAb are associated with a lower incidence of uveitis compared to placebo and anti-IL17A.

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